| NPI | 1962501098 |
|---|---|
| Doing Business As | MAPLE VALLEY PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | MICHAEL PORTACCI President 615-465-7029 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2022-07-21 |